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General NPI Number Information
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NPI Number | 1275944266
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Entity Type | Individual
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Provider Name | THOMAS CAMPBELL DPM
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Gender | Male
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Dates
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Enumeration Date | 05/13/2014
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Last Update Date | 05/09/2022
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Provider Practice Location Address
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Address Line | 4215 KIRCHOFF RD STE 104
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City | ROLLING MEADOWS
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State | IL
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Zip | 60008-2005
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Country | US
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Telephone | 312-202-6837
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Fax |
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Provider Business Mailing Address
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Address Line | 16 N YALE AVE
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City | VILLA PARK
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State | IL
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Zip | 60181-2339
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Country | US
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Telephone | 847-445-9003
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 016.005662
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License Number State | IL
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